scholarly journals Peritoneal dialysis associated-peritonitis: a preventable complication

2021 ◽  
Author(s):  
Regina De Miguel-Ibañez ◽  
Carlos Alberto Ramirez-Ramirez ◽  
Marcos Daniel Sanchez-Gonzalez ◽  
Angel Cesar Ortiz-Bello
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Standards Of Care ◽  
Total Annual Cost ◽  
World Population ◽  
End Stage ◽  
Preventable Complication ◽  
Main Complication

Peritoneal dialysis is useful renal replacement therapy for patients with end-stage chronic kidney disease. Latin America has 30% of the world population in peritoneal dialysis and within these countries Mexico covers 73% of them. In our country, the Mexican institute of social security (IMSS by its Spanish acronym) serves more than half of the Mexican population that requires renal replacement therapy. In 2014 it represented 15% of total annual cost of the institution. Peritonitis in peritoneal dialysis is the main complication seen in this renal replacement therapy with morbidity and mortality from 2 to 6%. The epidemiology of peritonitis associated with peritoneal dialysis varies according to the continent, country and dialysis center. The rate of peritonitis per year of each center reflects their quality of care. The prevention, diagnosis and treatment of peritonitis impact in the quality of life of the patient, the success of renal replacement therapy, public health costs and associated mortality. This review addresses the epidemiology, diagnosis, treatment, and preventive measures of peritonitis, focused on the procedures for improving the standards of care.

scholarly journals Periodontal Disease in Patients Receiving Dialysis

2019 ◽  
Vol 20 (15) ◽  
pp. 3805
Author(s):  
Yasuyoshi Miyata ◽  
Yoko Obata ◽  
Yasushi Mochizuki ◽  
Mineaki Kitamura ◽  
Kensuke Mitsunari ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Periodontal Disease ◽  
Replacement Therapy ◽  
Healthy Individuals ◽  
Progressive Loss ◽  
Medical Instruments ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Chronic kidney disease (CKD) is characterized by kidney damage with proteinuria, hematuria, and progressive loss of kidney function. The final stage of CKD is known as end-stage renal disease, which usually indicates that approximately 90% of normal renal function is lost, and necessitates renal replacement therapy for survival. The most widespread renal replacement therapy is dialysis, which includes peritoneal dialysis (PD) and hemodialysis (HD). However, despite the development of novel medical instruments and agents, both dialysis procedures have complications and disadvantages, such as cardiovascular disease due to excessive blood fluid and infections caused by impaired immunity. Periodontal disease is chronic inflammation induced by various pathogens and its frequency and severity in patients undergoing dialysis are higher compared to those in healthy individuals. Therefore, several investigators have paid special attention to the impact of periodontal disease on inflammation-, nutrient-, and bone metabolism-related markers; the immune system; and complications in patients undergoing dialysis. Furthermore, the influence of diabetes on the prevalence and severity of manifestations of periodontal disease, and the properties of saliva in HD patients with periodontitis have been reported. Conversely, there are few reviews discussing periodontal disease in patients with dialysis. In this review, we discuss the available studies and review the pathological roles and clinical significance of periodontal disease in patients receiving PD or HD. In addition, this review underlines the importance of oral health and adequate periodontal treatment to maintain quality of life and prolong survival in these patients.

scholarly journals Comparison of peritoneal dialysis and hemodialysis as first renal replacement therapy in patients with end-stage renal disease and diabetes: a systematic review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Yukio Maruyama ◽  
Chieko Higuchi ◽  
Hiroaki Io ◽  
Keiichi Wakabayashi ◽  
Hiraku Tsujimoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
End Stage Renal Disease ◽  
Risk Of Bias ◽  
Diabetic Patients ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Diabetes has become the most common cause of end-stage renal disease (ESRD) requiring renal replacement therapy (RRT) in most countries around the world. Peritoneal dialysis (PD) is valuable for patients newly requiring RRT because of the preservation of residual renal function (RRF), higher quality of life, and hemodynamic stability in comparison with hemodialysis (HD). A previous systematic review produced conflicting results regarding patient survival. As several advances have been made in therapy for diabetic patients receiving PD, we conducted a systematic review of studies published after 2014 to determine whether incident PD or HD is advantageous for the survival of patients with diabetes. Methods For this systematic review, the MEDLINE, EMBASE, and CENTRAL databases were searched to identify articles published between February 2014 and August 2017. The quality of studies was assessed using the GRADE approach. Outcomes of interest were all-cause mortality; RRF; major morbid events, including cardiovascular disease (CVD) and infectious disease; and glycemic control. This review was performed using a predefined protocol published in PROSPERO (CRD42018104258). Results Sixteen studies were included in this review. All were retrospective observational studies, and the risk of bias, especially failure to adequately control confounding factors, was high. Among them, 15 studies investigated all-cause mortality in diabetic patients initiating PD and HD. Differences favoring HD were observed in nine studies, whereas those favoring PD were observed in two studies. Two studies investigated effects on CVD, and both demonstrated the superiority of incident HD. No study investigated the effect of any other outcome. Conclusions In the present systematic review, the risk of death tended to be higher among diabetic patients with ESRD newly initiating RRT with incident PD in comparison with incident HD. However, we could not obtain definitive results reflecting the superiority of PD or HD with regard to patient outcomes because of the severe risk of bias and the heterogeneity of management strategies for diabetic patients receiving dialysis. Further studies are needed to clarify the advantages of PD and HD as RRT for diabetic patients with ESRD.

scholarly journals Successful Renal Replacement Therapy for a Patient with Severe Hemophilia after Surgical Treatment of Intracranial Hemorrhage and Hydrocephalus

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Noriko Kato ◽  
Masami Chin-Kanasaki ◽  
Yuki Tanaka ◽  
Mako Yasuda ◽  
Yukiyo Yokomaku ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Hemophilia A ◽  
Severe Hemophilia ◽  
End Stage Renal Failure ◽  
Japanese Male ◽  
Old Japanese ◽  
End Stage

A 21-year-old Japanese male with severe hemophilia A was developed end-stage renal failure. He was placed on combination therapy with peritoneal dialysis (PD) and hemodialysis (HD). Eight months later, he developed a hypertensive cerebral hemorrhage. After emergency surgery, he was managed with PD without HD to avoid cerebral edema. One month later, his renal replacement therapy was switched to HD (three times a week) from PD, since a ventriculoperitoneal shunt catheter was placed to treat his hydrocephalus. HD could be performed safety without anticoagulant agents on condition that factor VIII is given after every HD.

scholarly journals Incidence of end stage renal disease on renal replacement therapy in Nepal

1970 ◽  
Vol 7 (3) ◽  
pp. 301-305 ◽  
Author(s):  
R Hada ◽  
S Khakurel ◽  
RK Agrawal ◽  
RK Kafle ◽  
SB Bajracharya ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
End Stage Renal Disease ◽  
Female Ratio ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country. Objectives: The objective of this study is to find out the incidence of ESRD on renal replacement therapy and their out come. Materials and methods: It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients file, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profile, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis. Results: Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 ± 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT. Conclusion: The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to find out of cause of ESRD and to institute preventive measures.Key words: End stage renal disease; Renal replacement therapy; Haemodialysis; Intermittent peritoneal dialysis; Incidence of end stage renal disease; Nepal. DOI: 10.3126/kumj.v7i3.2742 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 302-305

Status of Renal Replacement Therapy and Peritoneal Dialysis in Mexico

2007 ◽  
Vol 27 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Alfonso M. Cueto-Manzano ◽  
Enrique Rojas-Campos
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Developed Countries ◽  
Technique Survival ◽  
Treatment Providers ◽  
The World ◽  
Stage Renal Disease ◽  
End Stage ◽  
Mexican Patients

Mexico is struggling to gain a place among developed countries; however, there are many socioeconomic and health problems still waiting for resolution. While Mexico has the twelfth largest economy in the world, a large portion of its population is impoverished. Treatment for end-stage renal disease (377 patients per million population) is determined by the individual's access to resources such as private medical care (approximately 3%) and public sources (Social Security System: approximately 40%; Health Secretariat: approximately 57%). With only 6% of the gross national product spent on healthcare and most treatment providers being public health institutions that are often under economic restrictions, it is not surprising that many Mexican patients do not receive renal replacement therapy. Mexico is still the country with the largest utilization of peritoneal dialysis (PD) in the world, with 18% on automated PD, 56% on continuous ambulatory PD (CAPD), and 26% on hemodialysis. Results of PD (patient morbi-mortality, peritonitis rate, and technique survival) in Mexico are comparable to other countries. However, malnutrition and diabetes mellitus are highly prevalent in Mexican patients on CAPD programs, and these conditions are among the most important risk factors for a poor outcome in our setting.

The quality of life of older and younger people who receive renal replacement therapy

2005 ◽  
Vol 25 (6) ◽  
pp. 903-923 ◽  
Author(s):  
KEVIN J. McKEE ◽  
STUART G. PARKER ◽  
JENNIFER ELVISH ◽  
VINCE J. CLUBB ◽  
MEGUID EL NAHAS ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Replacement Therapy ◽  
Literature Review ◽  
Replacement Therapy ◽  
Measurement Instruments ◽  
Duration Of Treatment ◽  
Health Status Measurement ◽  
Younger Patients ◽  
End Stage

The use of age as a criterion for the allocation of medical resources has been extensively debated internationally. This paper describes a study of the significance of age for the quality of life (QoL) of older and younger people with end-stage renal failure (ESRF) and in receipt of renal replacement therapy (RRT). The study has two components: a structured literature review to characterise the QoL and health-status measurement instruments that have been developed for use with all or specifically older RRT patients; and a longitudinal survey of the QoL domains nominated by older RRT patients by their age and duration of treatment. The literature review found that no validated QoL instrument had been developed specifically for use with older RRT patients. Moreover, there was little correspondence between the QoL domains used in the instruments described in the published literature and those mentioned by the survey participants. Older and younger patients nominated different domains, and their nominations changed with the duration of treatment. No significant differences in QoL scores were found between older and younger patients, but the scores improved significantly between 6–12 and 18–24 months of treatment. The findings suggest that using older age as a criterion for refusing full access to healthcare resources in ESRF is a simplistic and potentially erroneous strategy.

scholarly journals A Brazilian Experience in Assisted Automated Peritoneal Dialysis: A Reliable and Effective Home Care Approach

2013 ◽  
Vol 33 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Marcia Regina Gianotti Franco ◽  
Natália Fernandes ◽  
Claúdia Azevedo Ribeiro ◽  
Abdul Rashid Qureshi ◽  
Jose Carolino Divino–Filho ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Total Duration ◽  
Hemodynamic Instability ◽  
Technique Survival ◽  
Care Approach ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

IntroductionAutomated assisted peritoneal dialysis (AAPD) has been shown to be successful as renal replacement therapy for elderly and physically incapable end-stage renal disease (ESRD) patients. In early 2003, a pioneer AAPD program was initiated at GAMEN Renal Clinic in Rio de Janeiro, Brazil.ObjectiveWe evaluated the results of an AAPD program offered as an option to elderly ESRD patients with physical or cognitive debilities or as last resort to patients with vascular access failure or hemodynamic instability during hemodialysis.MethodsA cohort of 30 consecutive patients started AAPD from January 2003 to March 2008 and was followed to July 2009. Demographics, clinical and laboratory parameters, causes of death, and patient and technique survival were analyzed.ResultsMedian age of the patients was 72 years (range: 47 – 93 years), with 60% being older than 65. The Davies score was greater than 2 in 73% of patients, and the Karnofsky index was less than 70 in 40%. The overall peritonitis rate was 1 episode in 37 patient–months. The total duration of AAPD ranged from 3 to 72 months. Patient survival was 80% at 12 months, 60% at 24 months, and 23.3% at 48 months. The most common cause of death was cardiovascular problems (70%).ConclusionsIn this clinical observational study, AAPD fulfilled its expected role, offering an opportune, reliable, and effective homecare alternative for ESRD patients with no other renal replacement therapy options.

scholarly journals Complications of continuous ambulatory peritoneal dialysis: An early experience in tertiary hospital of Western region of Nepal

2017 ◽  
Vol 5 (2) ◽  
pp. 34-37
Author(s):  
Abhishek Maskey ◽  
Niraj Dhakal ◽  
Chirayu Regmi
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Diseases ◽  
Tertiary Hospital ◽  
Infectious Complications ◽  
Catheter Survival ◽  
End Stage ◽  
Complications Rate

Background and Aims: Chronic ambulatory peritoneal dialysis (CAPD) has been established form of therapy in adults patients with end stage kidney diseases and has emerged as a feasible modality of renal replacement therapy. The aim of the study was to evaluate the complications of CAPD and its contributing factor in order to improve the patient survival and reduce morbidity and mortality.Methods: A hospital based retrospective study of 35 patients who opted for CAPD at Manipal teaching hospital, Pokhara from 1st June 2015 to 31st May 2016 was carried out.Results: Total 35 CAPD patients were included in study. The mean age of the patients was 45.78±16.34 years. Nineteen (54%) patients were male. The total follow up was 533 patients months with mean follow up of 15.22 ±5.02 months. There were 41 episodes of different complications that occurred during the study period with rate of 0.9 episodes/patient years. There were 18 (43%) episodes of peritonitis including 5 recurrence of peritonitis in 5 patients, 6 (15%) exit site infections, 6 (15%) failure of drainage, 2 (5%) pericatheter leakage, 2 (5%) catheter displacement , 2 (5%) omental wrapping, 2 (5%) catheter removal, 2 (5%) mortality. The commonest pathogen for peritonitis was staphylococcus aureus in 5 (22%) episodes.Conclusion: Overall complications rate was comparable to other studies. Peritonitis rate has been declined in our study. The majority of non-infectious complications are treatable and do not interfere with the catheter survival. CAPD is a safe and viable mode of renal replacement therapy alternative to hemodialysis.Journal of Advances in Internal Medicine Vol.5(2) 2016: 34-37

In Vitro Closure Times (PFA-100) Are Different Between Peritoneal Dialysis and Hemodialysis

2020 ◽  
Vol 40 (05) ◽  
pp. 671-678
Author(s):  
Cenk Gokalp ◽  
Fatma Keklik Karadag ◽  
Matthias Christoph Braunisch ◽  
Christoph Schmaderer ◽  
Emrah Gunay ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Adenosine Diphosphate ◽  
Significant Difference ◽  
Function Analyzer ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Abstract Introduction Platelet dysfunction is not uncommon in patients with end-stage renal disease (ESRD). Type of renal replacement therapy may have an effect on platelet functions, which has not been well investigated. We evaluated in vitro closure time (CT) differences between peritoneal dialysis (PD) and hemodialysis (HD) patients using platelet function analyzer (PFA-100)and observed a significant difference between these renal replacement therapies. Methods Patients with ESRD undergoing PD (n = 24) or HD (n = 23) for more than 6 months were included. Blood samples for collagen/epinephrine (Col/EPI) and collagen/adenosine diphosphate (Col/ADP) measurements were obtained before HD at a mid-week session for HD patients and at an outpatient control time for PD patients. Results Three of 24 (12.5%) PD patients and 16 of 23 (69.5%) HD patients had prolonged PFA-100 Col/EPI, p< 0.001. Likewise, 4.2% of PD patients and 87.0% of HD patients had prolonged PFA-100 Col/ADP, p< 0.001. Moreover, the median times of PFA-Col/EPI and PFA-100 Col/ADP were significantly lower in PD patients compared with those of HD patients (p< 0.001). Multivariate analysis showed that the type of renal replacement was a risk factor for both elevated PFA-100 Col/ADP and PFA-100 Col/EPI after adjusted for platelets, hematocrit, and urea (p< 0.001). Conclusions The type of renal replacement therapy may have an effect on in vitro CTs; therefore, studies including more patients with long-term follow-up are needed to investigate if the difference has any impact on clinical outcomes.

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